Adjusted Executive
Appropriation Request Percent
2000-01 2001-02 Change Change
AGENCY SUMMARY
Community Projects Fund 15,545,293 0 (15,545,293) -100.00%
General Fund 6,511,029,400 7,048,075,000 537,045,600 8.25%
Special Rev.-Fed. 19,834,837,900 21,505,845,000 1,671,007,100 8.42%
Special Rev.-Other 2,024,098,500 2,152,996,000 128,897,500 6.37%
Fiduciary 2,725,000 2,965,000 240,000 8.81%
Enterprise 10,000 10,000 0 0.00%
Capital Projects Fund 11,600,000 11,600,000 0 0.00%
Capital Projects Fund-1996
CWA (Bondable) 60,000,000 50,000,000 (10,000,000) -16.67%
Federal Capital Projects Fund 48,477,000 53,659,000 5,182,000 10.69%
Fiduciary Funds -
Miscellaneous New York
State Agencies 0 1,000,000 1,000,000 --
Total for Agency: 28,508,323,093 30,826,150,000 2,317,826,907 8.13%
Total Contingency: 650,000,000 850,000,000 200,000,000 30.77%
Total for AGENCY SUMMARY: 29,158,323,093 31,676,150,000 2,517,826,907 8.64%
STATE OPERATIONS
General Fund 206,406,800 227,995,000 21,588,200 10.46%
Special Rev.-Fed. 3,275,044,400 3,392,061,000 117,016,600 3.57%
Special Rev.-Other 350,117,400 351,527,000 1,409,600 0.40%
Fiduciary 2,725,000 2,965,000 240,000 8.81%
Enterprise 10,000 10,000 0 0.00%
Fiduciary Funds -
Miscellaneous New York
State Agencies 0 1,000,000 1,000,000 --
Total for STATE OPERATIONS: 3,834,303,600 3,975,558,000 141,254,400 3.68%
Administration and Executive Direction
General Fund 18,758,400 17,291,000 (1,467,400) -7.82%
Special Rev.-Fed. 14,464,000 12,839,000 (1,625,000) -11.23%
Special Rev.-Other 24,877,600 29,917,000 5,039,400 20.26%
Total for Program: 58,100,000 60,047,000 1,947,000 3.35%
AIDS Institute
General Fund 16,838,700 16,851,000 12,300 0.07%
Special Rev.-Other 2,062,200 2,136,000 73,800 3.58%
Total for Program: 18,900,900 18,987,000 86,100 0.46%
Environmental Health
General Fund 9,797,000 10,204,000 407,000 4.15%
Special Rev.-Fed. 13,255,300 11,105,000 (2,150,300) -16.22%
Special Rev.-Other 13,819,200 14,290,000 470,800 3.41%
Total for Program: 36,871,500 35,599,000 (1,272,500) -3.45%
Community Health
General Fund 9,442,700 9,797,000 354,300 3.75%
Special Rev.-Fed. 103,759,700 98,268,000 (5,491,700) -5.29%
Special Rev.-Other 5,596,800 5,554,000 (42,800) -0.76%
Fiduciary Funds -
Miscellaneous New York
State Agencies 0 1,000,000 1,000,000 --
Total for Program: 118,799,200 114,619,000 (4,180,200) -3.52%
Laboratories and Research
General Fund 35,604,800 35,867,000 262,200 0.74%
Special Rev.-Fed. 7,962,200 7,932,000 (30,200) -0.38%
Special Rev.-Other 28,777,300 29,359,000 581,700 2.02%
Fiduciary 2,000,000 2,600,000 600,000 30.00%
Total for Program: 74,344,300 75,758,000 1,413,700 1.90%
Managed Care
General Fund 14,098,300 13,234,000 (864,300) -6.13%
Total for Program: 14,098,300 13,234,000 (864,300) -6.13%
Health Care Standards and Surveillance
General Fund 26,876,000 30,319,000 3,443,000 12.81%
Special Rev.-Other 42,022,300 43,372,000 1,349,700 3.21%
Total for Program: 68,898,300 73,691,000 4,792,700 6.96%
Health Care Financing
General Fund 5,934,800 5,575,000 (359,800) -6.06%
Special Rev.-Other 5,782,700 6,145,000 362,300 6.27%
Total for Program: 11,717,500 11,720,000 2,500 0.02%
Institution Management
Special Rev.-Other 111,707,000 102,860,000 (8,847,000) -7.92%
Fiduciary 325,000 325,000 0 0.00%
Enterprise 10,000 10,000 0 0.00%
Total for Program: 112,042,000 103,195,000 (8,847,000) -7.90%
Medicaid Management Information System
General Fund 48,676,000 60,766,000 12,090,000 24.84%
Special Rev.-Fed. 67,511,000 67,510,000 (1,000) -0.00%
Total for Program: 116,187,000 128,276,000 12,089,000 10.40%
Elderly Pharmaceutical Insurance Coverage
General Fund 12,320,600 11,039,000 (1,281,600) -10.40%
Total for Program: 12,320,600 11,039,000 (1,281,600) -10.40%
Office of Medicaid Audit and Fraud Prevention
General Fund 18,303,700 18,977,000 673,300 3.68%
Special Rev.-Fed. 34,563,500 36,566,000 2,002,500 5.79%
Special Rev.-Other 14,500,000 14,500,000 0 0.00%
Total for Program: 67,367,200 70,043,000 2,675,80 3.97%
Office of Continuing Care
General Fund 22,477,400 23,902,000 1,424,600 6.34%
Special Rev.-Fed. 12,778,000 61,000 (12,717,000) -99.52%
Special Rev.-Other 3,632,700 5,626,000 1,993,300 54.87%
Fiduciary 400,000 40,000 (360,00) -90.00%
Total for Program: 39,288,100 29,629,000 (9,659,100) -24.59%
Child Health Insurance
Special Rev.-Fed. 13,400,000 30,280,000 16,880,000 125.97%
Special Rev.-Other 11,251,600 11,680,000 428,400 3.81%
Total for Program: 24,651,600 41,960,000 17,308,400 70.21%
Maintenance Undistributed
General Fund (79,338,000) (78,338,000) 1,000,000 -1.26%
Special Rev.-Other 78,338,000 78,338,000 0 0.00%
Total for Program: (1,000,000) 0 1,000,000 -100.00%
Office of Medicaid Management
General Fund 46,616,400 52,511,000 5,894,600 12.64%
Special Rev.-Fed. 3,007,350,700 3,127,500,000 120,149,300 4.00%
Special Rev.-Other 7,750,000 7,750,000 0 0.00%
Total for Program: 3,061,717,100 3,187,761,000 126,043,900 4.12%
AID TO LOCALITIES
Community Projects Fund 15,545,293 0 (15,545,293) -100.00%
General Fund 6,304,622,600 6,820,080,000 515,457,400 8.18%
Special Rev.-Fed. 16,559,793,500 18,113,784,000 1,553,990,500 9.38%
Special Rev.-Other 1,673,981,100 1,801,469,000 127,487,900 7.62%
Total for AID TO LOCALITIES: 24,553,942,493 26,735,333,000 2,181,390,507 8.88%
Administration and Executive Direction
General Fund 869,300 869,000 (300) -0.03%
Total for Program: 869,300 869,000 (300) -0.03%
AIDS Institute
General Fund 61,556,700 53,656,000 (7,900,700) -12.83%
Special Rev.-Other 34,595,000 34,597,000 2,000 0.01%
Total for Program: 96,151,700 88,253,000 (7,898,700) -8.21%
Environmental Health
General Fund 1,500,000 6,000,000 4,500,000 300.00%
Special Rev.-Fed. 2,810,800 2,208,000 (602,800) -21.45%
Special Rev.-Other 200,000 200,000 0 0.00%
Total for Program: 4,510,800 8,408,000 3,897,200 86.40%
Community Health
General Fund 393,356,500 461,588,000 68,231,500 17.35%
Special Rev.-Fed. 584,097,900 569,686,000 (14,411,900) -2.47%
Special Rev.-Other 36,578,100 36,614,000 35,900 0.10%
Total for Program: 1,014,032,500 1,067,888,000 53,855,500 5.31%
Laboratories and Research
General Fund 1,071,000 1,071,000 0 0.00%
Special Rev.-Fed. 2,134,800 2,105,000 (29,800) -1.40%
Total for Program: 3,205,800 3,176,000 (29,800) -0.93%
Health Care Standards and Surveillance
General Fund 10,284,900 9,535,000 (749,900) -7.29%
Total for Program: 10,284,900 9,535,000 (749,900) -7.29%
Institution Management
General Fund 0 30,000,000 30,000,000 --
Total for Program: 0 30,000,000 30,000,000 --
Medical Assistance
General Fund 5,694,300,000 6,083,400,000 389,100,000 6.83%
Special Rev.-Fed. 15,300,500,000 16,424,000,000 1,123,500,000 7.34%
Special Rev.-Other 1,153,000,000 1,177,400,000 24,400,000 2.12%
Total for Program: 22,147,800,000 23,684,800,000 1,537,000,000 6.94%
Medical Assistance Administration
General Fund 87,750,000 78,557,000 (9,193,000) -10.48%
Special Rev.-Fed. 378,650,000 388,750,000 10,100,000 2.67%
Total for Program: 466,400,000 467,307,000 907,000 0.19%
Elderly Pharmaceutical Insurance Coverage
General Fund 252,200,000 360,400,000 108,200,000 42.90%
Total for Program: 252,200,000 360,400,000 108,200,000 42.90%
Office of Continuing Care
General Fund 11,342,200 7,342,000 (4,000,200) -35.27%
Special Rev.-Fed. 0 315,000 315,000 --
Total for Program: 11,342,200 7,657,000 (3,685,200) -32.49%
Child Health Insurance
Special Rev.-Fed. 291,600,000 726,720,000 435,120,000 149.22%
Special Rev.-Other 240,000,000 280,320,000 40,320,000 16.80%
Total for Program: 531,600,000 1,007,040,000 475,440,000 89.44%
Community Projects
Community Projects Fund 15,545,293 0 (15,545,293) -100.00%
Total for Program: 15,545,293 0 (15,545,293) -100.00%
Maintenance Undistributed
General Fund (209,608,000) (272,338,000) (62,730,000) 29.93%
Special Rev.-Other 209,608,000 272,338,000 62,730,000 29.93%
Total for Program: 0 0 0 --
CAPITAL PROJECTS
Capital Projects Fund 11,600,000 11,600,000 0 0.00%
Capital Projects Fund-1996
CWA (Bondable) 60,000,000 50,000,000 (10,000,000) -16.67%
Federal Capital Projects Fund 48,477,000 53,659,000 5,182,000 10.69%
Total for CAPITAL PROJECTS: 120,077,000 115,259,000 (4,818,000) -4.01%
Laboratories and Research
Capital Projects Fund 4,000,000 4,000,000 0 0.00%
Total for Program: 4,000,000 4,000,000 0 0.00%
Maintenance and Improvements of Existing Institutions
Capital Projects Fund 7,600,000 7,600,000 0 0.00%
Total for Program: 7,600,000 7,600,000 0 0.00%
Water Resources
Federal Capital Projects Fund 48,477,000 53,659,000 5,182,000 10.69%
Total for Program: 48,477,000 53,659,000 5,182,000 10.69%
Safe Drinking Water - Clean Water/Clean Air 96
Capital Projects Fund-1996
CWA (Bondable) 60,000,000 50,000,000 (10,000,000) -16.67%
Total for Program: 60,000,000 50,000,000 (10,000,000) -16.67%
CONTINGENCY
Fiduciary 650,000,000 850,000,000 200,000,000 30.77%
Total for CONTINGENCY: 650,000,000 850,000,000 200,000,000 30.77%
Medical Assistance
Fiduciary 650,000,000 850,000,000 200,000,000 30.77%
Total for Program: 650,000,000 850,000,000 200,000,000 30.77%
ALL FUNDS PERSONNEL
BUDGETED FILL LEVELS
Current Requested
Program 2000-01 2001-02 Change
Suballocation 12 12 0
Administration and Executive
Direction 520 538 18
AIDS Institute 218 214 (4)
Environmental Health 427 423 (4)
Community Health 659 651 (8)
Laboratories and Research 658 658 0
Managed Care 155 155 0
Health Care Standards and
Surveillance 536 536 0
Health Care Financing 129 129 0
Institution Management 1,569 1,569 0
Elderly Pharmaceutical
Insurance Coverage 28 28 0
Office of Medicaid Audit and
Fraud Prevention 484 509 25
Office of Continuing Care 398 408 10
Child Health Insurance 42 42 0
Office of Medicaid Management 387 387 0
Total General Fund : 2,540 2,525 (15)
Total All Other Funds : 3,682 3,734 52
TOTAL: 6,222 6,259 37
BUDGET HIGHLIGHTS
(Executive Budget: pp.133-141)
As the designated State agency responsible for promoting and supervising
public health activities, ensuring sound and cost effective quality medical
care, and reducing infectious diseases, the Department of Health (DOH) works
towards its goal of ensuring the highest quality, most appropriate and
cost-effective health care for all New Yorkers. Since State Fiscal Year
(SFY) 1996-97, when authority for the State's Medical Assistance (Medicaid)
Program was transferred from the former Department of Social Services, the
Department of Health has also served as the principal State agency responsible
for interacting with the Federal and local governments, health care providers,
and program participants on behalf of the Medicaid Program in New York.
Transfer of all Medicaid functions to the Department of Health consolidated
for the first time in one agency the operational and oversight responsibilities
for the Medicaid Program, thereby clarifying State accountability for Medicaid
policy and allowing for greater efficiencies in the administration of
health care programs.
This Agency is contained in the Health, Mental Hygiene and Environmental
Conservation appropriation bill.
The Governor recommends All Funds appropriations for the Department of Health
totalling $31,676,150,000, an increase of $2,517,826,907, or 8.64 percent over
State Fiscal Year (SFY) 2000-01 primarily attributable to an increase in Federal
Funds. The Governor recommends General Fund appropriations for the Agency
totaling $7,048,075,000, an increase of $537,045,600 or 8.25 percent over
last year. Additionally, the Governor recommends Special Revenue Funds-Federal
appropriations for the Agency totaling $21,505,845,000, an increase of
$1,671,007,100 or 8.42 percent over last year.
State Operations
The Executive recommends a total All Funds appropriation for State
Operations of $3,975,558,000, which reflects an increase of $141,254,400
or 3.68 percent over SFY 2000-01. This increase due primarily to increased
federal funds in the Office of Medicaid Management. The Executive proposes
General Fund State Operations appropriations totaling $227,995,000, an
increase of $21,588,200 or 10.46 percent over SFY 2000-01. The Executive
also recommends Special Revenue Funds-Federal totaling $3,392,061,000 for
State Operations, which is an increase of $117,016,600 or 3.57 percent over
the previous year.
The Executive proposes the creation of 10 new positions in the Office of
Continuing Care at a General Fund cost of $450,000 to conduct nursing home
surveillance activities. The Executive also proposes creating 25 new
positions in the Office of Medicaid and Fraud Prevention to increase
anti-fraud efforts. Of these 25 new positions, 13 are proposed to
be paid for from the General Fund at a cost of $312,000.
Other notable changes proposed by the Executive in State Operations include:
-- a $5,466,000 General Fund increase for the implementation of the Health
Information Quality Improvement Act of 2000, commonly referred to as
"Physician Profiling." This new appropriation plus the proposed
reappropriation of $3,000,000 reappropriation will bring total funding
for this initiative to $8,466,000;
-- a new $514,000 Special Revenue Funds-Other fund to collect fees related
to the Funeral Direction Administration Program;
-- a new $2,000,000 Special Revenue Funds-Other fund to establish a Quality
of Care Improvement Account, which will be used for the purpose of
protecting the health and property of residents in residential health care
facilities;
-- a new $250,000 Maintenance Undistributed appropriation for Syringe
Access Demonstration Program costs related to the distribution of
public information on syringe availability; and
-- a $600,000 increase in the Breast Cancer Research and Education Fund
to provide a State match for funds donated annually by taxpayers through
the income tax check-off.
Institutional Management
As part of the enacted Health Care Reform Act (HCRA) of 2000, the
Roswell Park Cancer Institute was scheduled to receive $90,000,000 in
calendar year 2000; $60,000,000 in 2001; $40,000,000 in 2002, and
$20,000,000 as half year funding in 2003.
In the Executive 2001-02 Budget, the Governor recommends a $30,000,000
decrease in funding for the Roswell Park Cancer Institute from HCRA for
calendar 2000 and proposes the substitution of a $30,000,000 General Fund
appropriation in SFY 2001-02 to cover the proposed HCRA funding reduction.
The Department of Health currently maintains four direct care institutions:
Helen Hayes Hospital in West Haverstraw and three nursing homes for the
care of veterans and their dependents - Oxford, New York City, and Western
New York. The Executive also proposes a $9,667,000 funding increase for the
Montrose Veterans' Nursing Home, which is a new, 252-bed facility in the
lower Hudson Valley scheduled to open early in SFY 2001-02.
Aid to Localities
The Executive recommends All Funds appropriations totaling $26,735,333,000,
which is an increase of $2,181,390,507 or 8.88 percent over the SFY 2000-01
funding level. This increase is primarily attributable to an increase in
Special Revenue-Federal Funds in the Medicaid Program.
The Executive proposes General Fund appropriations totaling $6,820,080,000,
an increase of $515,457,400 or 8.18 percent over SFY 2000-01. The
Executive also recommends a Special Revenue Fund-Federal, totaling
$18,113,784,000 for Aid to Localities, which is an increase of
$1,553,990,500 or 9.38 percent over the previous year.
For the Early Intervention Program, the Executive recommends an
appropriation of $155,700,000, an increase of $20,700,000 over SFY 2000-01
funding level. While the proposed appropriation anticipates enrollment
growth, the Executive expects to partially offset such growth by maximizing
the use of Medicaid reimbursement for approximately 10,000 Medicaid eligible
children within the next two years. Such action is expected to hold actual
General Fund spending for the Early Intervention Program to the current
fiscal year level of $130,000,000.
In SFY 2001-02, the Executive recommends an appropriation of $360,400,000,
year-to-year for the Elderly Pharmaceutical Insurance Coverage (EPIC)
Program. This $108,200,000 net increase is associated with the EPIC
expansion provisions enacted in SFY 2000-01 which increased income
eligibility to $35,000 for singles and $50,000 for married couples.
In addition, the EPIC expansion reduced annual fees and co-payments by 20
percent and reduced co-payment thresholds by five percent. The EPIC
expansion also reduced the number of co-payment amounts from five to four.
Additionally, the EPIC expansion simplified the program structure by
limiting the fee plan to incomes up to $20,000 for singles and $26,000 for
married couples and by providing that eligible persons with incomes over
these amounts will be in the deductible plan.
The Executive anticipates that the EPIC General Fund appropriation of
$95,000,000 for SFY 2001-02 would have to be approximately $40,500,000
higher were it not for various offsets being taken by the Executive.
These offsets include: $30,000,000 from reducing pharmacy reimbursement
from 95 percent of the Average Wholesale Price (AWP) to 90 percent of the
AWP; $4,500,000 from altering the drug rebate methodology to mirror that
of the Medicaid Program by applying the Consumer Price Index (CPI)
methodology used to calculate Medicaid rebates to EPIC rebates; and
$6,000,000 from requiring private health insurers to match membership
files with EPIC enrollee files to facilitate coordination of benefits.
In the Child Health Insurance Program (CHIP), the Executive recommends a
$492,748,400 increase for SFY 2001-02. Of this amount, $435,000,000 is
attributed to the share that New York State recently received as a
result of an allocation of federal CHIP funds unspent by other states in
Federal Fiscal Year 1998. The Executive also proposes accessing
$69,000,000 from unspent HCRA 1996 funds, which will be used to offset
CHIP expenditures from HCRA 2000. In addition, the Executive proposes
Article VII legislation to extend the current CHIP program without change
until June 30, 2003. The program is presently scheduled to expire on
March 31, 2001.
The Executive recommends an appropriation of $194,900,000, an increase
of $28,900,000 for the General Public Health Works Program to support
local public health activities. The Executive also recommends a separate
$21,900,000 appropriation in the General Public Health Works Program to
pay for activities related specifically to the West Nile encephalitis
outbreak, including epidemiology, surveillance, laboratory testing,
spraying, larvicidal treatment, and general public information. The
Executive continues language that implements restrictions on the use of
local tobacco settlement funds for matching State reimbursement except
in the case of a public health emergency.
The Executive recommends $5,000,000 in new funding for the Newborn
Hearing Program to screen newborns and to ensure identification and
treatment of infants with hearing impairments. This program will
reimburse institutions for the cost of the testing and administration
to carry out this program. Children receiving Medicaid services would
be covered for this testing under the Medicaid program. Children that
are ineligible for Medicaid services, but uninsured, would still be
tested with the cost being reimbursed by the State at the proposed
Medicaid rate of $27.84 per child.
The Executive continues $2,400,000 SFY 2000-01 in Legislative enhancements
to the Healthy Women Partnerships Program and adds an additional $1,600,000
in new funding for SFY 2001-02 to increase breast and/or cervical screening
services.
Despite the escalating needs of community providers as HIV/AIDS caseloads
continue to grow, the Governor fails to recommend any new or additional
spending in the AIDS Institute; in fact, he cuts $7,901,000 in funding
added by the Legislature in SFY 2000-01. The effect is the elimination
of total funding for some programs, such as treatment compliance.
Other notable changes proposed by the Executive in Aid to Localities include:
-- a $3,700,000 General Fund increase to support the immunization of
underinsured children under 59 months with a new pneumonia vaccine
which has recently been added to the Federal Vaccines For Children
Program;
-- a $700,000 General Fund increase for the Indian Health Program associated
with increased pharmaceutical costs; and,
-- a $500,000 General Fund increase for the creation of a Pharmaceutical
and Therapeutic Committee, which will consider measures to promote the
appropriate and cost-effective provision of pharmaceuticals and make
recommendations regarding the drug formulary and utilization policies.
Medical Assistance (Medicaid) Program
As part of the Health Care Reform Act of 2000 agreement, the Medicaid cost
containment measures, enacted as part of the SFY 1999-2000 budget, were
extended for three years, until March 31, 2003, with the understanding that
no new cuts would occur during this period of time. Despite this
understanding, the Executive proposes new cuts to the State's
Medicaid Program.
The Executive recommends an All Funds Medicaid appropriation in Aid to
Localities of $23,684,800,000, which is a net increase of $1,537,000,000
resulting from an increase in Federal Funds. The Executive estimates
that total All Funds expenditures for the Medicaid Program, including
Mental Hygiene related expenditures, will be $30.8 billion in the
current fiscal year. Without the implementation of proposed new cost
containment actions, the Governor expects expenditures would rise to
$32.4 billion due to growth in entitlement spending.
The Governor's SFY 2001-02 Medicaid cost-containment package will result
in the loss of more than $350,000,000 in combined Federal, State, and
local reimbursement to certain Medicaid providers. These new cuts are
targeted primarily at nursing homes, but also impact certified home
health care agencies and the pharmaceutical industry. As estimated by
the Executive, these cuts will produce State share savings to the
Medicaid Program of $138,900,000. Specifically, the Governor proposes:
eliminating the 2001-02 trend factor for nursing homes, $50,000,000;
removing a supplemental payment to facilities that have more than 300
beds, $23,900,000; eliminating the return on equity incentives to
proprietary homes, $11,000,000; updating the nursing home reimbursement
methodology by eliminating the cost of Medicare and all other non-Medicaid
patients from the Medicaid rate, $46,000,000; and establishing a fixed
cap on Certified Home Health Care Agency administrative costs, $2,000,000.
Additionally, the Executive proposes savings totaling $6,000,000
related to pharmaceutical efficiencies.
The Executive estimates General Fund disbursements in the Department of
Health in SFY 2000-01 will be $5,692,800,000. For SFY 2001-02, the
Executive proposes a total General Fund appropriation of $6,083,400,000,
an increase of $390,600,000 or 7.0 percent over the current fiscal
year. This appropriation reflects the total General Fund benefit to
the Medicaid Program of the proposed new cost containment actions
which the Executive estimates at $300,100,000. Of this amount,
$138,900,000 is achieved through the previously mentioned cuts to
providers while another $160,000,000 is effectuated through revenue
and other Federal maximization efforts designed to offset Medicaid.
Additionally, the Executive proposes eliminating the transfer of
$82,000,000 from HCRA of 2000 to offset General Fund Medicaid funding.
The Executive also proposes decreasing Supplementary Medical Insurance
funding distributions in HCRA 2000, by a total of $25,000,000 for the
periods January 1, 2000 to June 30, 2003. These two actions taken
together would provide for the elimination of $107,000,000 which would
have been used to offset General Fund Medical
Assistance spending.
The Executive's proposed SFY 2001-02 budget also includes $3,200,000
for new Medicaid expansions. The Executive proposes $500,000 in SFY
2001-02 to provide Medicaid coverage up to 250 percent of the Federal
Poverty Level (FPL) to uninsured and underinsured women diagnosed with
breast cancer or cervical cancer through the Center for Disease
Control's national screening program, effective October 1, 2001. When
the program is fully implemented, the Executive estimates that approximately
77,000 women will benefit from the expansion. In addition, the
Executive proposes $2,700,000 in SFY 2001-02 for administrative costs
associated with the creation of the Medicaid Buy-In Program for
the Working Disabled. Beginning January 1, 2002, the Governor's
proposal would authorize Medicaid coverage for disabled persons up to
250 percent of the FPL and with up to $10,000 in resources. When
the program is fully implemented, the Executive estimates that
approximately 19,000 persons will benefit from the expansion.
The Executive also proposes moving approximately 10,000 Early
Intervention recipients into the Medicaid Program. While the
Executive anticipates savings to the EI program from this move,
the Executive recognizes increased cost to the Medicaid program
and adds $1,550,000 for this purpose.
Additionally, the Executive has indicated proposing legislation,
titled the Nursing Home Quality Improvement Act, to improve the
quality of care in nursing homes. The proposed legislation will
require criminal background checks for all nursing home employees
who provide direct care to residents; increase fines on nursing homes
for deficiencies, imposing higher fines for nursing homes with repeat
violations; grant the Commissioner of Health the authority to replace
"bad operators" of nursing homes without going through the courts; and
create a new nursing home complaint hotline to enable inspectors to
better track, coordinate and respond to patient complaints.
Article VII
In the Article VII bill, the Executive proposes:
-- extending the Child Health Insurance Program (CHIP) from
March 31,2001 until July 1, 2003;
-- continuing additional Disproportionate Share Payments for
the Health and Hospital Corporation (HHC) Hospitals;
-- authorizing hospital proportionate share Medicaid payments for
certain non-State operated public facilities, assigning responsibility
for Medicaid payments to the local social services district where
the hospital is located, and; authorizing Medicaid payments
at 50 percent Federal and 50 percent local shares;
-- authorizing Federal Financial Participation (FFP) for inpatient
hospital and other services provided to inmates in State and local
government facilities;
-- establishing a Medicaid Buy-In Program authorizing Medicaid coverage
for disabled persons up to 250 percent of the Federal Poverty Level
(FPL) and $10,000 in resources, effective January 1, 2002;
-- authorizing a Medicaid expansion up to 250 percent of the FPL for
low income women who are diagnosed with breast and/or cervical cancer
through the national Centers for Disease Control's screening program,
effective October 1, 2001;
-- authorizing reductions in local share reimbursement due to New York
City for persons eligible for Medicaid as a result of a mental
disability;
-- eliminating the transfer of $82,000,000 from the Health Care Reform
Act of 2000 to offset General Fund Medical Assistance spending;
-- transferring $69,000,000 in residual HCRA 1996 funds into the Child
Health Insurance Program Account to offset Child Health Insurance
expenditures, and using any unused or uncommitted funds remaining
in HCRA 1996 after the $69,000,000 transfer will be used for the
funding of other programs in HCRA 2000;
-- decreasing from $90,000,000 to $60,000,000 the Roswell Park Cancer
Institute funding level in HCRA 2000 for the period January 1, 2000
through December 31, 2000;
-- decreasing the Supplementary Medical Insurance (SMI) funding
distributions in HCRA 2000 by a total of $25,000,000 for the periods
January 1, 2000 through June 13, 2003;
-- eliminating the return on equity for proprietary nursing homes,
beginning April 1, 2001 through June 30,2003;
-- eliminating annual inflationary payment increases, beginning
April 1, 2001 through June 30, 2003;
-- changing the Medicaid rate methodology by removing the cost of Medicare
and all other non-Medicaid patients from the Medicaid rate, effective
April 1, 2001 through June 30, 2003;
-- requiring managed care recipients to make a co-payment on prescription
drugs similar to other Medicaid recipients;
-- prohibiting Medicaid capital reimbursement for any new residential
health care facility bed that has not received final approval to
commence construction as of January 1, 2001;
-- extending the historical cost methodology for reimbursing nursing
home capital costs;
-- extending Prepaid Health Services Plans (PHSPs) through
June 30, 2002; and,
-- establishing the Quality of Care Improvement Account to receive all
penalty and fine revenues collected by the Department of Health and
the Federal Department of Health and Human Services from residential
health care facilities.
In the Elderly Pharmaceutical Insurance Coverage (EPIC) Program,
the Executive proposes:
-- lowering the pharmacy reimbursement from 95 percent of the
Average Wholesale Price (AWP) to 90 percent of the Average
Wholesale Price;
-- applying the Consumer Price Index (CPI) methodology to EPIC rebates;
-- permitting EPIC enrollees to have other pharmaceutical coverage;
-- requiring private health insurers to match membership files with the
EPIC program to facilitate a coordination of benefits; and,
-- authorizing the Commissioner of Health, upon recommendation from the
EPIC panel, to allow the EPIC program to reimburse for a drug not
covered by a rebate agreement if the drug offers effective therapy or
substantially improves treatment of a disease than would otherwise be
available.
Capital Projects
The Executive recommends an All Funds Capital Projects appropriation of
$115,259,000, which is a net decrease of $4,818,000 due to a reduction in
the Capital Projects Fund-1996 CWA Bondable.